Medical Modesty

A growing movement within healthcare has placed a spotlight on an issue that’s often overlooked by clinicians and providers: medical modesty. Modest patients who begrudgingly disrobe at a provider’s request with little argument or protest are becoming empowered and vocal about their privacy rights, and it’s a trend that urgent care would do well to pay heed.

As highlighted in a story reported by the Chicago Tribune, patients concerned about modesty during examinations and procedures have long felt providers haven’t been sensitive or accommodating enough. Drawing on data and anecdote provided by the North Carolina non-profit Medical Patient Modesty, the story lays bare the often-unspoken anxiety and anger felt by certain patients when required to expose their bodies while receiving medical care.

Medical modesty can have its root in religious, cultural, or personal concerns. Muslims, for example, may have strict requirements about the gender of their provider. Or a female patient may be uncomfortable being touched by a male physician. Often, though, busy or understaffed providers don’t give modesty much thought given their constant exposure to partial nudity. Further, female patients are generally afforded more consideration than male patients who may be equally modest.

Indeed, medical modesty is a very real issue, and its one in which many patients will go to great lengths to secure. Modest patients will often travel long distances to be seen by accommodating providers, while others may delay or forgo care altogether. And in extreme cases, patients have filed lawsuits against providers when they’ve felt their unique privacy needs went unheard or were violated.

As it pertains to urgent care, which entails short visits for treating minor medical issues, most modesty complaints surround the genital region. A provider treating a STD/STI or an UTI may need to view or palpate the genitals, for instance. This is unacceptable for some patients, particularly if the provider is of the opposite gender. Even inquiring about sensitive and highly personal topics relating to sexual activity and drug use can raise modesty concerns.

Urgent care relies heavily on repeat visits and positive word-of-mouth, though, so raising awareness of how to honor and accommodate medical modesty can be beneficial to the bottom line. “We recognized that it was not only patients who request same gender providers and staff when they present for treatment but staff and providers may also have the same concerns, even when a patient doesn’t,” says Cindy Lang, RN and CEO of DocNow Urgent Care in Rochester Hills, Michigan. “Education and training needs to factor for both scenarios with a goal to promote understanding of diversity when cultural and personal issues are present.”

Suzy Buck, Director of Marketing for ZipClinic urgent care, which operates centers in Kentucky, Colorado, and Montana, expresses a similar sentiment. “We provide same sex providers for female patients as this is a sensitive area for many religions. In addition, if we have in-person interpreters, we also provide same sex interpreters as they can then be in the exam room to translate, as many women from other religions cannot answer certain questions if a male is present.” ZipClinic also offers a phone translation service to allow a patient to hear, in their native language, what the provider will exam that day. The center found that even if a patient’s English is good, hearing the examination details in their native tongue is reassuring, and makes the experience more comfortable.

As DocNow and Zipclinic illustrate, the concept of medical modesty is easy to grasp and implement in an urgent care setting. Clinic operators wanting to incorporate a culture of medical modesty can use the following suggestions as guidelines:

• Modify intake forms such that they include modesty questions.
• Provide cloth gowns, as opposed to their paper counterparts, to patients who must disrobe. A paper gown is awkward to unfold, tears easily, and is rigid and uncomfortable for many patients.
• Implement protocols to ensure disrobing is only requested as necessary for the nature of the exam.
• Install curtains in exam rooms, particularly those used for gynecological/pelvic exams. Hence, If the exam room door were to inadvertently be opened, the patient would not be exposed to passersby.
• Make chaperons of the same gender as the patient available. Chaperons can increase the patient’s comfort level while reducing the risk to the doctor of a false sexual harassment claim.
• Install signage throughout the clinic indicating that the practice cares about patient modesty. The signage should also implore patients to raise any concerns with the provider, and that chaperons are available upon request.

In short, medical modesty is about patient empowerment. By ensuring that patients – regardless of their cultural, religious, or personal inclinations – have their modesty and privacy honored, an urgent care center can reap huge benefits in patient goodwill, repeat visits, and positive word-of-mouth.

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